Oct
06
2018

Health Risks After Hurricanes

By | Infectious Disease, Lung Disease, Mortality, Prevention

We hear a lot about the dangers of hurricanes when they are in a region, but very little regarding health risks after hurricanes. I thought it would be interesting to review all of the health risks in a blog.

Health risks during a hurricane

A lot of the health risks during a hurricane are directly related to the risks from the wind severity, the amount of rain per hour and the physical damage from the hurricane. The excessive wind can uproot trees and they may fall right onto a house. This happened in the beginning of hurricane Florence. The amount of rain that comes down in a short time frame can be astounding. It causes flooding, which together with the high wind speeds can make you lose your footing. There is flying debris, torn away pieces of wood and drywall that can become a hazard to any person. It is a hazard that could kill you right there. It is best to be out of the way of a hurricane, if you can at all. But you need to watch hurricane predictions on the Internet or the news, so you know what is going on long before the hurricane arrives. This gives you enough time to travel away from the danger zone. People who live on islands need to be particularly proactive, so that they get out of harms way in time.

Be safe from floodwaters

If you live in a low-lying area, it is safer for you to leave and go to a shelter before the hurricane hits. Otherwise you end up drowning. Being on top of your house in a hurricane is dangerous as the roof may fly off any minute from the force of the wind. You are also the target of flying debris, wood pieces and other flying objects.

Contaminated water is one of the major health risks after hurricanes

With hurricane Maria in 2018 it appeared in the first few days that only 16 to 18 people had died from the physical effects of the hurricane in Puerto Rico. But in the subsequent weeks and months people died en masse because of infections from contaminated drinking water. It is unbelievable that huge water supplies had been brought in by FEMA following the hurricane Maria, but it was not distributed to the people who needed it. The total death toll is now around the 3000 mark. FEMA calculated this by subtracting 13,000 deaths due to natural causes from the total deaths of 16,000. The difference is about 3,000 deaths, attributable to hurricane Maria.

Providing clean drinking water important

Providing clean drinking water should be the first priority following a hurricane. This will prevent that people get the typical water-born bacterial and viral illnesses following a hurricane.

One patient in Puerto Rico with chronic emphysema was on a breathing machine. The interruption of electricity as a result of hurricane Maria meant his death. Some people are so vulnerable that the interruption of electricity ends their life.

Communicable diseases from floodwaters

The WHO has brought out a fact sheet regarding communicable diseases from floodwaters. People need to be aware that floodwaters are contaminated and avoid them as much as possible. However, they also point out that unless you have bruises or cuts where bacteria from contaminated waters could grow the danger is smaller than generally believed.

Mold from water damage to houses

After hurricane Katrina in New Orleans 2005 there was a lot of mold growth in houses that were flooded. This caused an overwhelming odor that was difficult to cope with. Bleach water removes mold initially until a professional crew can clean it up at a later date. I mention this here because following a hurricane there will not be enough professional people around to help. Mold is particularly devastating for asthmatics and people with chronic respiratory conditions. These people need evacuation from such living environments until the house is clean from molds. Flare-ups of asthma and chronic obstructive pulmonary disease can be deadly. Under normal circumstances people with respiratory problems can manage, but these people are at a severe risk of dying from an aggravation of their underlying conditions. Hurricane Katrina will be remembered for this.

Living in destroyed homes

Often with a direct hit of hurricane the roofs of homes are missing. The hurricane ripped them off and they literally flew away. A home without a roof is prone to water damage from future precipitation. There is the danger of mouse and rat infestation. Birds can enter and partake in the leftover meals. Their droppings may contain contagious bacteria like salmonella causing typhoid fever. Builders  work hard and long hours; it can take months or years before life is normal again. It may be wiser to live with a relative for a few months until the house is in livable condition again. When electricity is restored and the water lines are functioning again, there may still be an issue about getting safe drinking water and uncontaminated water to have showers and baths. Also, without proper shelter there are risks of mosquitoes transferring communicable diseases. This happened in the Dominican Republic.

Malaria in the Dominican Republic

In September 2004 Hurricane Jeanne struck the Dominican Republic. Subsequently there was more flooding from heavy rainfalls. The end result was a mini-epidemic of 17 cases of malaria, because the flooded areas gave the mosquitoes more breeding ground to multiply. Fortunately no one died, as all the malaria cases responded to chloroquine and primaquine. But some patients had to be treated in the Intensive Care Unit of a hospital. As already mentioned there are other water born illnesses that can cause diarrhea, vomiting and fever. These people need to get immediate access to a hospital where the medical staff will rehydrate them intravenously. Otherwise they could die.

Health Risks After Hurricanes

Health Risks After Hurricanes

Conclusion

Hurricanes pose enormous problems for the communities where landfall occurs. Close to the eye of the hurricane are the worst structural damages to properties and trees. But even miles away from that there can be flooding due to excessive winds and rain. Most people are reasonable during the initial phase when the hurricane hits. This means they stay inside so they can protect themselves from the direct impact of the storm. But hurricanes can pull roofs off and people can get hurt.

Illnesses from contaminated water

Later there is a disruption of the electrical supply as well as the water supply. The restoration of the utilities may take days or weeks. Immediately you depend on fresh and clean water supply, and when you run out, there may not be enough fresh water available. Illnesses from contaminated water become a huge problem at that point. This is where a lot of mortality comes from in the aftermath of a hurricane.

If you can, it is wiser to escape this all by visiting a relative far away from the hurricane area. In this case you must leave well in time before the hurricane hits. You can check with the authorities when it would be safe to return home. At least you know that you have survived. Everything else can wait. You will gradually take care of it. But it may take a long time for things to return to normal.

Feb
03
2018

Drugs Are Not An Escape

By | addiction, alcohol, Arthritis, Drugs, Pain, stem cells, Substance abuse

We have a drug epidemic, but drugs are not an escape. Along with this epidemic there have been thousands of lethal overdoses. I like to review why so many people use street drugs or prescription pain pills. It started years ago with heroin injections had become more popular. But then heroin was getting a bad name, it became illegal, and prescription pain pills replaced heroin. Percocet, OxyContin and morphine prescriptions took off. Together with it the number of people with addiction increased drastically. The latest fashion craze is Fentanyl.  Fentanyl works faster than morphine, but also wears off faster. One of the deadly side effects is respiratory depression. This  means that a person cannot breathe and as a result will die. This is what is happening right now and what creates the news headlines.

Pain receptors

There are pain receptors all over the body, in muscles, organs and the skin. They are called nociceptors. Many medical conditions lead to pain in various parts of the body. For instance, with end stage degenerative arthritis bone rubs on bone. This causes a lot of pain in joints like the knees or the hips. Physicians often prescribe narcotics like OxyContin to control the pain. It may help for some time. But after a few weeks patients complain that the strength of OxyContin has worn off. The same dosage that gave them relief from the pain initially just does not give them relief any more. This observation is crucial. It is exactly what people who use OxyContin as illicit street drug found as well. The drug wears off, because the opioid receptors are getting weaker.

Pain receptor resistance

Nociceptors or opioid receptors are pain receptors. These receptors report pain to the body, and they have connections through the spinal cord to the brain. When an opioid is interacting with the pain receptor it inhibits acute pain to a large extent. But when the pain becomes chronic, the pain receptor is not working as well. More and more of the pain medication is necessary to achieve pain relief.  Eventually the opioid medication is not working to relieve pain any more. The name for this phenomenon is “pain receptor resistance”. Scientific work behind why pain receptors get lazy in responding to opioids is still ongoing. In the meantime it simply is an observation. This is the reason why drug addicts are tending to increase the dosage of OxyContin or of Fentanyl. The toxic threshold of Fentanyl that is exceeded in the process is the reason for the deaths.

Insulin resistance

You may have heard of insulin resistance in diabetics. This is a very similar problem. With insulin resistance the diabetic no longer has a 100% response to insulin. This means that blood sugar is not going through cell membranes effectively as it should when the insulin receptor is working. The blood sugar values stay high and make the diabetes worse.

With pain receptor resistance the opioid is not giving the relief from pain it used to give. No wonder that the patient is feeling frustrated that the pain medication is no longer working properly.

Therapeutic index

The layperson does not normally know that there is a dosage for any drug where it becomes toxic. There is also a lower dosage where the drug is becoming effective. The difference between the two dosages is the “therapeutic window” or the “therapeutic index”.

Morphine has a therapeutic index of 70:1. Compare that to alcohol with a therapeutic index of only 10:1. Fentanyl has a therapeutic index of 300:1.

The danger of Fentanyl

One would think that Fentanyl should be safer than morphine, because the therapeutic index is larger. But the onset of Fentanyl is much faster than that of morphine and by the time drug users take Fentanyl they often are desperate for the drug to take their pain away and they overdose, which causes respiratory depression. If they are not intubated by an anesthetist and connected to artificial respiration, they die very quickly. Janssen Pharmaceutica first developed Fentanyl in 1959. Fentanyl was strictly part of the pre-anesthetic medicine for patients before going into surgery requiring a general anesthetic. The anesthetist was right there and would intubate the patient. That’s why we never heard of deaths from Fentanyl in the past.

If a person gets no pain relief from any opioid because of receptor resistance, the tendency is to increase the dosage. But this is what pushes the person into toxic ranges and this is what causes death from inadvertently suppressing the ability to breathe. People can get into trouble with alcohol overdoses, but the ordinary person usually knows how to handle alcohol. Fentanyl is a lot different due to the fact that respiratory depression (not being able to breathe) is one of the early symptoms that hits you suddenly.

What drugs do to your brain

Dr. Daniel Amen, a psychiatrist and brain researcher has used SPECT brain scans to produce images of different clinical conditions. This link shows the effect of a stroke, of Alzheimer’s disease and of drug abuse on the brain. Dr. Amen says that a brain can be rehabilitated. He has other SPECT images showing the images of an addicted brain and that of a rehabilitated brain. Spect scans are expensive.  But they may be worth it, to impress a drug addict to stop the drugs and get rehabilitated.

Big Pharma and opioid drugs

In 1995 the FDA approved the use of OxyContin for chronic pain. Perdue Pharma, the drug company that had developed this opioid convinced the FDA that OxyContin stayed in the blood for 12 hours and they claimed that by being active longer than other opioids this would lead to better pain control and less addiction. It turns out that this was a slick sales pitch, however it was not true. Pain receptor resistance is as much a problem with OxyContin as with any other opioid. And the drug is as addictive as all the others. But the problem is that the FDA had approved OxyContin. What’s more, Purdue Pharma sent aggressive drug representatives to all the practicing physicians misleading them as well as the FDA that OxyContin would not be as addictive as other opioids.

Penalty for misrepresentation of OxyContin

In 2007 Purdue Pharma had to pay a fine of 634 million $ for misrepresenting the addiction potential of OxyContin. But the drug company was allowed to continue to market OxyContin. Since 2015 Purdue Pharma has been cashing in 2.4 billion $ annually from the sales of opioids including OxyContin. In the meantime Fentanyl, despite its danger of suppressing the ability to breathe, has taken off with regard to sales. Fentanyl also has taken over in terms of causing deaths across the US and other countries.

Alternative treatment of pain

According to Ref. 1 chances are that 70% of patients with back pain will get better with a few visits to an acupuncturist. In 1972 Dr. Ulett’s laboratory at the University of Missouri succeeded in getting the first NIH research grant for the study of acupuncture in the US. During these studies they found remarkable facts, the most important perhaps that electrical stimulation of acupuncture needles resulted in a doubling of the effectiveness of traditional Chinese acupuncture. After extensive research Dr. Ulett stated: ”The ancient practice of traditional Chinese acupuncture is now obsolete” (Ref.1). in the meantime the more effective electro-acupuncture has replaced acupuncture needles with the use of electrical skin pads.”

Other applications for electroacupuncture

Beside pain relief many other applications exist for electro-acupuncture. Addiction medicine makes use of electro-acupuncture in weaning people from morphine or heroine etc. It is effective to treat psychiatric illness, particularly depression. It is useful in relieving nausea and vomiting due to chemotherapy with cancer treatments or associated with pregnancy without affecting the pregnancy.

Prolotherapy

Prolotherapy has been successful for the treatment of back and neck pain, for arthritic pain and pain from chronic muscle spasm. When prolotherapy is done by itself 12.5% Dextrose is injected into the area of injury. Dr. Fields said that the reason it works is that there is activation of local stem cells in the injured area in the area of the Dextrose injection site. These stem cells will do the healing (details explained in an interview with Dr. Reeves). Further improvement of this technique and better results are possible by injecting a small amount of platelet rich plasma (PRP) very focally to an area of ligament rupture. PRP is obtained by centrifuging blood from the patient’s vein. The red blood cells are not necessary, but the platelet fraction and some of the plasma are part of the the PRP preparation.

It is often striking how much pain control occurs after only one or two prolotherapy treatments.

Stem cell therapy with PRP and low-dose laser therapy

This is a more direct way to get stem cells where the doctor wants them to do their work. Stem cell therapy with PRP and low-dose laser activation is the latest in terms of controlling pain. At the 22nd Annual Anti-Aging Conference in Las Vegas (Dec.10 to 14, 2014) Dr. Purita gave an overview of this method of pain control. He discussed the importance of the proper harvesting of PRP. He explained that apart from white blood cells (WBC) and platelets an important component of PRP are very small embryonic like stem cells (VSELs). They are visible through the microscope. The missing link has been the observation that white blood cells produce inflammatory substances, which have been detrimental in stem cell injections with PRP in the past. There was a poor survival rate of stem cells.

Low dose laser activation of stem cells and PRP

Photo-activation of the PRP before injection leads to anti-inflammatory behavior of the WBC in PRP. Dr. Purita calls this “light activated PRP”, which leads to the best results with stem cell/PRP injections.

Soft laser stimulation with red, green and blue soft lasers have also been effective to improve tissue healing significantly when stem cells and PRP are used together with light activation. The main sources for good stem cells are the fat tissue (from the “love handles”) and the bone marrow (obtained from pelvic bone). The stem cells mesenchymal stem cells (from fatty tissue) and bone marrow stem cells. The mix of all of this can mend osteoarthritic joints, degenerative disc of the spine, in short all musculoskeletal injuries that may be painful. The hallmark of healing with stem cells is that chronic pain disappears.

Curative treatment versus symptomatic treatment

It is one thing to treat a patient for pain symptomatically by prescribing OxyContin or other opioids. It is a completely other thing when the physician cures the pain by one of these alternative methods. Let us assume that a patient has a fall of a few step from a ladder and sustains a contusion of the lower back. This can be painful and may require a few pain pills. But if it does not improve within one week and diagnostic tests show that there is no fracture, electroacupuncture may be the solution to treat the pain rather than the use of an opioid. If this does not help, consider the combination stem cell/PRP/low-dose laser therapy. Chances are better than 80% that this will help. The patient will no longer suffer of pain. With healing life can go on: no pain pills. No addiction. No death.

Drugs Are Not An Escape

Drugs Are Not An Escape

Conclusion

Conventional medicine treats pain symptomatically instead of treating the cause. It gets the physician to prescribe opioids, which can be the beginning of a series of tragic events. It can lead to drug addiction, dose acceleration, toxic effects of opioids including possible death through asphyxiation from no longer being able to breathe.

Stem cell therapy

The physician who concentrates on treating causes will use alternative methods to treat pain. The most effective of these methods is stem cell therapy. It is a mixture of adipose mesenchymal stem cells with bone marrow stem cells that are part of the therapy. The addition of platelet rich plasma is another part of the mix, and the final step is activation of stem cells with low-dose laser therapy. The cell mix is injected in the critical area. The end result is that the patient’s pain disappears, and it leads to a cure. The only situation where short-term opioids are justifiable is following surgical procedures. But even in these cases the narcotics should only be necessary for a few days to avoid serious side effects.

Reference 1: George A. Ulett, M.D., Ph.D. and SongPing Han, B.M., Ph.D.: “The Biology of Acupuncture”, copyright 2002, Warren H. Green Inc., Saint Louis, Missouri, 63132 USA

More info about electroacupuncture: https://www.askdrray.com/electro-acupuncture-twice-as-effective-as-conventional-acupuncture/

More about prolotherapy stem cell therapy: https://www.askdrray.com/prolotherapy-and-stem-cell-therapy/

May
21
2014

Forty Percent Of Premature Deaths Can Be Prevented

By | Cancer, Diabetes, Fitness, Health, heart attack, Heart Disease, High Blood Pressure, Lung Disease, Nutrition, Obesity, Prevention, Stroke, Vitamins and supplements

A new report from the CDC (Center of Disease Control) in the US has revealed that up to 40% of premature deaths could be prevented by simple lifestyle changes. As this link shows every year about 900,000 premature deaths occur in the US, which are due to 5 major diseases that in the opinion of the CDC can be prevented by 20 to 40%. Here are the diseases that kill: cancer, heart disease, COPD/emphysema, stroke and accidents/injuries. These conditions were responsible for 63% of all deaths in the US in 2010.

Let’s discuss each of these conditions and how one could lower the risk of dying from them.

1. Cancer:

The Framingham Heart Study has shown that smoking and cancer are closely related. Smokers who quit can significantly reduce their risk of getting cancer. We also know that exercise and prophylactic supplements like fish oil and vitamin D3 have cancer preventative effects.

Antioxidant supplementation that included beta-carotene, vitamin A, vitamin C, and vitamin E daily or on alternate days for 1 to 12 years, along with selenium supplementation reduced the incidence of cancer of the esophagus, colon, pancreas, stomach or the liver. Insulin resistance due to sugar and starch overconsumption is causing cancer, particularly breast cancer, colorectal cancer and endometrial cancer. I have discussed this in a recent blog.

Pollution has been linked to increased lung cancer risks as discussed here.

2. Heart disease:

Heart disease can be caused by several factors in combination. Lifestyle issues are important: Smokers need to quit smoking as the Framingham Heart Study has shown more than fifty years ago that smoking causes heart attacks. Obesity and diabetes also contribute significantly to the risk of heart disease. Often these are connected to faulty nutrition, which is another lifestyle issue that comes to mind when too much sugar and starchy foods are taken in; your liver will convert these into fatty acids, triglycerides and elevated, oxidized LDL cholesterol, which gets deposited under the lining of the arteries. A lack of exercise adds to this problem as a lack of exercise lowers the protective HDL cholesterol and fat is deposited under the lining of the arteries. Start exercising and your protective HDL cholesterol will rise, your total cholesterol to HDL ratio will lower to healthier levels and your risk for hardening of the arteries and for getting a heart attack will fall. If you have diabetes, it is important that you manage your blood sugars well; this means that if you inject insulin, you want the blood sugar tests to be within the normal range and the hemoglobin A1C values to be below 5.5%. Poorly controlled diabetes is an important cause of heart attacks and strokes. High blood pressure is also an important cause of developing heart attacks and strokes. It is important to control your blood pressure by taking blood pressure lowering pills and also by exercising regularly. Exercise seems to send a signal to relax the blood vessels thus lowering the blood pressure, which in turn prevents heart attacks.

Forty Percent Of Premature Deaths Can Be Prevented

Forty Percent Of Premature Deaths Can Be Prevented

 

3. COPD/emphysema:

Chronic obstructive pulmonary disease (COPD) or emphysema is mostly caused by chronic exposure to cigarette smoke from smoking. The earlier you can quit, the better your chances that your breathing will not be the limiting factor when you age. But it is also important to avoid exposure to other noxious gases, such as from welding and from exposure to pollution. This may involve a decision to move to a less polluted area. Or it might involve a job retraining. Those who are suffering from COPD can be helped to a certain extent by a portable oxygen tank with nasal prongs.

4. Stroke:

As mentioned before, quitting smoking, controlling high blood pressure and controlling blood sugar, if you suffer from diabetes have been shown to stabilize your blood vessels including the ones that supply your brain. The key is to prevent hardening of the arteries by a healthy lifestyle. Exercising and keeping your weight under a body mass index of 25.0 have been shown to be effective stroke prevention. Healthy nutrition as indicated above under “heart disease” is equally important for stroke prevention. Go green (eat more vegetables, consume more green smoothies), cut down grains, sugar and starchy foods and you will live longer without strokes and heart attacks. Remember, what’s good for your heart is good for your brain!

5. Unintentional accidents/injuries:

Wearing helmets when bicycling, wearing seat belts when driving in a car, avoiding risky behaviors are all measures that save lives. One factor stands out in all of this: if you drink too much, you run the risk of being involved in unintentional accidents or injuries. People may not like to hear this, but your brain lacks the natural inhibitory impulses when you are under the influence of alcohol, so you become more daring and you may not pay attention for the split second that could have prevented an injury or accident. People react very differently to alcohol. Some people feel inebriated after only ½ a glass of wine or beer whereas others can drink more before they make mistakes. The best is to be sober when you drive, ski, use power tools or walk in traffic. Even climbing ladders requires a clear mind!

Conclusion:

As the CDC said 20 to 40% of premature deaths (deaths that occurred before the age of 80) could have been prevented, if the above-mentioned recommendations were followed. Let me rephrase this: 180,000 to 360,000 premature deaths every year in the US before the age of 80 could have been prevented! Curative medicine cannot help with these statistics as a heart attack or stroke has happened when it has struck you. Cancer and end stage lung disease are similar conditions that you are suddenly faced with when they occur and unintentional accidents just seem to happen. This is where the importance of prevention can be seen, because these little baby steps every day are adding up to something formidable, a force to be reckoned with. Be part of the solution, think prevention!

More information on:

1. Cancer mortality: http://nethealthbook.com/cancer-overview/overview/cancer-mortality-rate/

2. Higher vitamin D3 intake lowers mortality from heart attacks, strokes, cancer, fractures due to osteoporosis: http://nethealthbook.com/news/higher-vitamin-d-levels-associated-lower-risk-mortality/

Last edited Nov. 8, 2014

Feb
01
2014

Early Alcohol Use Will Result In Memory Loss Later In Life

By | Cancer, Health, Heart Disease, High Blood Pressure, Prevention, Substance abuse, Vitamins and supplements

Researchers found that heavy alcohol use in males during midlife paves the way to memory loss from dementia later in life.

I thought that this would be a good topic to review the effect of alcohol in general. Alcohol is a known cell poison, yet cardiologists keep on referring to the beneficial effects of that 1 glass of wine per day that will prolong your life. I will attempt to explain these diverse effects, where small amounts are supposed to be good for you while high amounts can be very damaging.

Review of the effects of alcohol

50% of the world population drinks alcohol, 10% to 20% have chronic alcoholism (Ref.1).  Just recently a Guardian news study was released showing that an astounding 25% of Russian men die before reaching the age of 55, compared to only 7% of men in the United kingdom and less than 1% of men in the US. The study looked at the effects of consuming large amounts of vodka.  There are about 10 million chronic alcoholics in the US. Chronic alcohol consumption leads to 100,000 deaths every year in the US. More than 50% of these deaths are from traffic accidents, the rest from medical problems caused by alcohol (Ref.1). Most of the alcohol gets detoxified through the liver cells and is metabolized into acetaldehyde. This involves the cytochrome P-450 system. That means that when a person also takes narcotics, sedatives or psychoactive drugs that are also metabolized through this liver enzyme system drugs and alcohol are taking much longer to be metabolized. This can lead to lethal overdoses that we hear about on TV all the time, hence the warning that you must not mix alcohol with drugs.

Early Alcohol Use Will Result In Memory Loss Later In Life

Early Alcohol Use Will Result In Memory Loss Later In Life

Alcohol is a cell and nerve poison. The most vulnerable organs in the body are the liver, brain, heart, pancreas, bone marrow and stomach. So, here are a number of conditions caused by drinking alcohol:

a)    Anemia: When a person drinks heavily and regularly anemia shows up in a blood test. Alcohol has a toxic effect on the bone marrow, which interferes with the production of red blood cells. But certain vitamins required by the bone marrow to manufacture red blood cells are often also missing in the diet of an alcoholic, which contributes to anemia as well.

b)    Cirrhosis of the liver develops in 10% to 20% of heavy drinkers. With cirrhosis part of the liver cells get replaced by fibrotic tissue and in advanced cases this can lead to a hepatic coma and death. Others are developing alcoholic hepatitis. This is an inflammation of the liver with fever and jaundice where the skin and eyeballs turn yellow. It is associated with severe abdominal pain.

c)    Gastritis: Alcoholic gastritis is common, but often undetected. The affected individual may just have stomach pains for a few days, or vomit food and/or blood in addition. With continued use of alcohol it may turn chronic. Alcoholic gastritis can turn into gastric ulcers with massive bleeding that often lead to death.

d)    Pancreatitis: The pancreas is a particularly vulnerable glandular tissue, which gets damaged by regular alcohol intake and with chronic alcohol intake gets partially replaced by fibrotic tissue causing the feared and painful chronic pancreatitis. This is a condition with vomiting and severe abdominal pains that can be unrelenting.

e)    High blood pressure, seizures, dementia, depression, heart irregularities and nerve damage:

You may ask yourself how all of these conditions would be reasonably under one heading. The heading for this is “nerve damage”. Let me explain: The sympathetic nerve is very sensitive to alcohol toxicity and when the sympathetic nerve fibers are damaged, you will develop high blood pressure. You see your physician, get blood pressure medication, but the pressure is difficult to control, if you continue to drink alcoholic beverages. It does not make sense to just add blood pressure pills and hope that this will cure your problem. Seizures are due to direct nerve damage in the more sensitive parts of the brain, which will cause these areas to produce extra electrical activities, which we call seizures. Again, just treating with anti-seizure medications is not the solution. Avoidance of alcohol is the other part of the treatment schedule. Dementia from heavy alcohol use is due to direct nerve atrophy in the brain. Our brain shrinks normally 1.9% to 2.8% per decade, depending on which research papers you read. But in the presence of heavy drinking the frontal lobe of the brain is particularly vulnerable to brain shrinkage.

As this publication shows, mild and moderate drinkers did not suffer more frontal lobe shrinkage than abstainers, but heavy drinkers had a 1.8-fold higher risk of frontal lobe shrinkage on average when compared to abstainers. It was calculated that alcohol had contributed 11.3% to that frontal lobe shrinkage.

The rest of the toxic effect on the nerve tissue explains why depression would develop. The frontal brain contains most of the serotonin producing nerve cells. When serotonin-producing nerve fibers get damaged, the body does not produce enough serotonin to prevent depression from setting in; GABA producing cells often also get damaged, which causes anxiety. It’s not good enough to just prescribe anxiolytic drugs to which the patient will get addicted. The whole person needs to be treated, and abstinence from alcohol has to be part of the program.

Heart irregularities (atrial fibrillation, ventricular fibrillation) can be life-threatening complications due to the toxic effect of alcohol on the nerve fibers within the heart muscle. Emergency physicians are aware of the connection of these conditions to alcohol consumption. Some people’s hearts are more sensitive to the effects of alcohol than others. The most common cause of temporary atrial fibrillation is excessive alcohol intake (holiday heart) according to Ref. 2.

Finally there is the effect of alcohol on nerves in the body. This explains that heavy alcohol consumers can come down with painful pins-and-needles sensations in their hands and feet or with numbness or loss of muscle strength. When the parasympathetic nervous system is affected embarrassing incontinence or constipation can result. Erectile dysfunction in men is also very common. Viagra and continuing to drink is not the solution.

f)      Gout: This painful formation of uric acid crystals in joints can be precipitated in sensitive individuals by consuming alcohol in combination with eating large helpings of beef. There may be a history of gout in the family. Treatment for this is to refrain from alcohol and avoid foods that are leading to uric acid production when ingested.

g)    Cancer: When the body detoxifies alcohol in the liver, the breakdown product is acetaldehyde, which is a known cancer producing substance. A whole array of cancers are known, which come from heavy, chronic alcohol consumption: cancers in the mouth, larynx, esophagus, stomach, pancreas, liver and colorectal cancer have all been linked to excessive alcohol intake.

h)    Cardiovascular disease: heart attacks and strokes can be caused particularly by binging; it is thought that binging makes platelets from the blood more sticky so they clump together and cause blood clots, which in turn leads to heart attacks and strokes.

i)      Infections: Alcohol weakens the immune system, which is another effect on the bone marrow similar to causing anemia, except that this is the toxic effect on the white blood cells and lymphocytes. Heavy alcohol consumers are more prone to pneumonia, to HIV, sexually transmitted diseases, and tuberculosis.

Cardiology view of preventative alcohol

Despite all of these hair raising toxic effects cardiologists have painted the rosy picture that 1 glass of wine for women and 2 glasses of wine for men per day will prevent heart disease. What is the true story here?

Ref.2 points out that there are about 100 prospective studies that confirm that there is an inverse relationship between mild to moderate alcohol consumption and “heart attack, ischemic stroke, peripheral vascular disease, sudden cardiac death, and death from all cardiovascular causes”. It describes further that the reduction of risk in these various studies was persistent and consisted of a 20% to 45% risk reduction. Using blood tests investigators have found that this is because of an increase of HDL cholesterol, reducing blood clotting, making platelets less sticky and reducing inflammation as evidenced by a reduction of the C-reactive protein. Further research has pinpointed that it is the phenols and resveratrol that are contained in alcoholic beverages that are responsible for the beneficial effects. The bad news is that three glasses of wine or more do the opposite, so does binge drinking. Unless you are extremely disciplined and never increase your allowed limit (1 drink for women, 2 drinks for men) you will CAUSE heart disease rather than PREVENT it (Ref.2). Some people have a family history of breast cancer or colon cancer and they should avoid alcohol altogether; also people coming from alcoholic families should avoid alcohol.

Conclusion

Where does this leave us with regard to prevention of heart attacks, strokes and hardening of the arteries in the legs (peripheral vascular disease)? If you are disciplined and stick to the limits, you could prevent 20% to 45% of cardiovascular risk. The brain study mentioned in the beginning of the blog would also confirm that there was no difference between dementia or brain shrinkage when mild to moderate drinkers were compared to abstainers over 10 years. What is not told by the wine industry is that the same effects that prevent cardiovascular disease in mild to moderate drinkers can also be achieved by natural means: exercising regularly will raise your protective HDL cholesterol; taking ginkgo biloba, flax seed and omega-3 fatty acids thins your blood and the platelets are getting less sticky; omega-3 reduces inflammation and resveratrol elongates telomeres making you live longer. At the A4M conference in Las Vegas in December 2011 there were three speakers who pointed out that even small amounts of alcohol will poison mitochondria of your cells and interfere with normal hormone action. This was enough to make me join those who abstain alcohol completely. One thing has not yet been investigated in long-term studies, namely how small effects of alcohol may affect the body over several decades and over an entire lifetime. Despite all the promises of interest groups that red wine is a trendy drink for those interested in heart health, the fundamental long-term studies are missing. What does a guy do with a healthy heart and a brain that is not functioning too well? I just do not want to be the guinea pig in that worldwide study.

More information on alcoholism: http://nethealthbook.com/drug-addiction/alcoholism/

References:

  1. Kumar: Robbins and Cotran: Pathologic Basis of Disease, Professional Edition, 8th ed. © 2009 Saunders
  2. Bonow: Braunwald’s Heart Disease – A Textbook of Cardiovascular Medicine, 9th ed. © 2011 Saunders

Last edited Nov. 7, 2014

Jan
31
2013

Staying Healthy During Exotic Travel

By | Health, Infectious Disease, Prevention, vaccinations

A study of 82,825 ill travelers from Europe, North America, Israel, Japan, Australia and New Zealand was published who were interested in staying healthy during exotic travel. They had traveled the world between June 1996 and August 2011. The data was based on the GeoSentinel surveillance network database. There were 3,655 patients (4.4%) who were seriously sick with one of 13 tropical diseases. There were 13 deaths (=0.4%), 10 of which were from malaria. Two died from melioidosis. This is an infectious disease caused by a bacterium found in soil in Southeast Asia (including Thailand, Laos, southern China, Singapore, Malaysia, Burma and Vietnam), Taiwan and northern Australia. One person died from severe dengue. The interesting fact is that there was not a single case of Ebola virus, although this is a highly publicized and lethal illness in Africa. The majority of travelers sustained malaria and typhoid.

The tropical diseases were either due to viral illnesses, bacterial infections or protozoan infections.

Frequent viral illnesses encountered by visitors to Asia were dengue hemorrhagic fever (DHF) or dengue shock syndrome (DSS); avian influenza, Lassa fever as well as other tropical hemorrhagic fevers, Japanese encephalitis including other tropical encephalitis cases, Rift Valley fever and yellow fever.

This is a list of the bacterial infections that were reported: Anthrax, Carrion’s disease (=Bartonella bacilliformis), epidemic typhus, leptospirosis, melioidosis, murine typhus, paratyphoid fever, plague, relapsing fever, scrub typhus, spotted fever group rickettsioses and typhoid fever.

An interesting side-note is that even in familiar places like Hawaii leptospirosis is re-emerging as this link shows. So, it is important for visitors to Kauai and the Big Island of Hawaii (Waipio valley) to refrain from swimming in streams or natural ponds and to not expose your face to cascading waterfalls as leptospirosis can enter through the eyes, the nose, the mouth and scratches on the skin.

Finally, the following protozoan infections were found frequently: East African sleeping sickness, falciparum malaria and Plasmodium knowlesi malaria.

Staying Healthy During Exotic Travel

Staying Healthy During Exotic Travel

Each travel region has its special infection characteristics. With travel to Central America infectious diseases ranked in decreasing frequency like this: typhoid fever, leptospirosis, falciparum malaria and paratyphoid fever. In the Caribbean falciparum malaria was followed by typhoid fever, leptospirosis and paratyphoid fever. In South America the highest on the list was again falciparum malaria, followed by typhoid fever, paratyphoid fever and leptospirosis. In Sub Saharan Africa the highest number of falciparum malaria cases were registered (2633 of them), followed by 42 cases of typhoid fever, paratyphoid fever and leptospirosis. In the Middle East only one case of falciparum malaria, one case of typhoid fever and 2 cases of paratyphoid fever were reported. In contrast there were many more infections reported in South Central Asia (India): 286 cases of typhoid fever, followed by parathyroid fever, falciparum malaria and leptospirosis. All of the cases of typhoid fever and parathyroid fever in India were adequately treated with antibiotics and no deaths resulted from that. This is an example where no vaccine is available for prevention, but swift medical treatment could help immediately when an infection had occurred.

In South East Asia (Malaysia, Philippines, Indonesia) leptospirosis was on top, followed by typhoid fever, falciparum malaria and parathyroid fever. North East Asia (Korea, Mongolia), had only 3 cases of typhoid fever and 1 case of paratyphoid fever. Oceania (Polynesia) reported 26 cases of falciparum malaria, followed by paratyphoid fever and typhoid fever.

Several interesting observations were made with regard to this study.

  1. Most patients with travel acquired tropical illnesses presented within less than 17 days at the doctor’s office at home and 91% of them had developed a fever.
  2. The spectrum of the tropical disease that was diagnosed and treated varied according to the geographic destination where the traveler had been, which is consistent with the observations mentioned above (different distribution of tropical diseases depending on which area was traveled). Visitors to West Africa had a high rate of falciparum malaria, visitors to India sustained largely enteric fevers; and leptospirosis,  scrub typhus and murine typhus were the dominant tropical diseases for visitors to South East Asia.
  3. Males were found to be less diligent in using chemoprophylaxis for malaria prior to their travel than females. Overall only a minority had attended a travel clinic prior to their travel for immunizations and chemoprophylaxis for preventable tropical disease such as malaria.
  4. Other global life-threatening diseases like meningitis, other forms of septicemia, severe bacterial pneumonia and legionnaires also have to be considered as they occurred in roughly 30% of returning travelers.
  5. Malaria was the largest percentage of the tropical diseases that travelers brought home and 67% of all cases were male patients. They were mostly visiting West Africa where they acquired malaria (typically from Nigeria,  Ghana and the Ivory Coast). As mentioned they accounted for 10 of the 13 deaths.

The authors recommend that travelers should prepare themselves for trips to the tropics and subtropics, preferable visiting one of the travelers’ clinics. The recommended procedures should be followed meticulously. Not all of the diseases can be prevented, but if the traveler turns sick, they should seek medical advice as soon as possible in the country where they travel as these physicians often have special expertise in these tropical diseases.

One of the comments of the study was that often people visit relatives and friends in an area where tropical disease exists without any chemoprophylaxis or vaccinations beforehand. The visitors were under the impression that prior living in the area as a child would still protect them now during the travel as an adult, which is not the case. This can be prevented by visiting a travel clinic well before the planned trip, so there is enough time for vaccinations and possible blood tests.  

More information on:

1. Traveler’s diarrhea:  http://nethealthbook.com/infectious-disease/parasites/travelers-diarrhea/

2. Parasites: http://nethealthbook.com/infectious-disease/parasites/